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CONTINENCE CENTER MEDICAL GROUP INC. NPI 1295748861


NPI Information

NPI: 1295748861
Provider Name: CONTINENCE CENTER MEDICAL GROUP, INC.

Doing Business As: SOUTHERN CALIFORNIA CONTINENCE CENTER, A MEDICAL CORPORATION

Classification: Urology - 208800000X
Entity Type: Organization

CLIA Number: 05D1058170

Address:
320 SUPERIOR AVE
#110
NEWPORT BEACH, CA
ZIP 92663
Phone: (949) 480-9659
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CONTINENCE CENTER MEDICAL GROUP, INC. is an urology in Newport Beach, CA. The provider is a urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. CONTINENCE CENTER MEDICAL GROUP, INC. NPI is 1295748861. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Southern California Continence Center, A Medical Corporation.

The provider's business location address is:

320 SUPERIOR AVE
#110
NEWPORT BEACH, CA
ZIP 92663-716
Phone: (949) 480-9659

The provider's authorized official is Jill Byers .
The authorized official title is Owner and has the following contact phone number (949) 515-3777.

The CLIA number assigned to this NPI record is 05D1058170 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/14/2006 and was last updated on 2/11/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208800000XUrologyG74895CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11295748861OTHERCALIFORNIANPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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